Abstract:
INTRODUCTION:Mortality of prostate carcinoma can be significantly decreased by the use of modern diagnostic and therapeutic options. Patients in early stages can be cured by radical surgery or radiotherapy. AIM:Overview and comparison of previous and present diagnostic and therapeutic methods regarding accuracy of diagnosis, improvement of efficiency and decrease of toxicities. We also aimed to explore general correlations in case of serious complications. METHOD:By the help of two prostate cancer patients we demonstrate the importance of accuracy and change of histological diagnosis, significance of proper imaging techniques, and also show parameters of conventional and modern radiotherapy and their acute and chronic complications. Differences of previous and present methods and their consequences were analyzed. RESULTS:By now, histological findings in the patients' diagnosis have changed. Both patients received conventional three-dimensional definitive radiotherapy in 2009-2011, and their prostate cancer was cured. In one case, urinary bladder also received radiotherapy because prostate carcinoma had infiltrated it. In the other case, the contemporary radiotherapy involved urinary bladder's fundus due to safety margins. Although acute grade 2 cystitis developed in both cases and recovered in several weeks, as late complication bladder shrinkage developed, which after the ineffectiveness of conventional therapies had to be cured by radical cystoprostatectomy - in order to cease bleeding and to cure incontinence. CONCLUSIONS:In case of prostate carcinomas, serious complications can be avoided by the improvement of diagnostic and therapeutic options. Synthesis of data could be more successful if they were analyzed in the light of previous experiences. Orv Hetil. 2018; 159(32): 1317-1325. :Absztrakt: Bevezetés: A korszerű diagnosztikus és kezelési lehetőségek igénybevételével a prosztatarák mortalitása jelentősen csökkenthető. A korai stádiumú daganatos betegek radikális műtéttel vagy sugárkezeléssel is meggyógyíthatók. Célkitűzés: A jelenlegi kivizsgálási és a terápiás módszerek áttekintése és összehasonlítása a korábbi gyakorlattal a diagnózis pontossága, a hatékonyság javítása és a mellékhatások csökkentése szempontjából, valamint általános összefüggések megvilágítása súlyos szövődményes esetek kapcsán. Módszer: Két prosztatadaganatos eset mentén ismertetjük a pontos szövettani diagnózis jelentőségének és változásának, a megfelelő képalkotó vizsgálatok alkalmazásának, a besugárzás hagyományos és modern paramétereinek, valamint a sugárkezelés akut és késői szövődményeinek részleteit. Elemzésre kerülnek a korábbi és a napjainkban alkalmazott módszerek lényegi különbségei és ezek konzekvenciái is. Eredmények: Betegeink diagnózisában napjainkra módosult a szövettani vélemény. Mindkét esetben 2009–2011-ben hagyományos, 3 dimenziós konformális technikával definitív sugárkezelés történt, melynek hatására meggyógyultak prosztatatumorukból. Az egyik beteg besugárzást kapott a hólyagra is, mivel a daganat beszűrte azt. A másiknál a biztonsági zóna kiterjesztése miatt, a kor színvonalán álló besugárzás a hólyagalapot is kiterjedtebben érintette. Bár mindkét esetben hetek alatt szanálódott a hevenyen jelentkező kettes fokozatú cystitis, mégis késői szövődményként zsugorhólyag alakult ki. Ezek elhárítására – az első esetben a vérzés megállítására, a második esetben az incontinentia megszüntetésére – a hagyományos eljárások kudarca miatt radikális cystoprostatectomiára volt szükség. Következtetések: A prosztatadaganatok diagnosztikai és terápiás fejlődésének összetett lépései együttesen vezetnek a súlyos szövődmények elkerüléséhez. Az adatok szintézise azonban akkor lehet még sikeresebb, ha azokat a korábbi tapasztalatok birtokában is elemezzük. Orv Hetil. 2018; 159(32): 1317–1325.
journal_name
Orv Hetiljournal_title
Orvosi hetilapauthors
Varga L,Bajory Z,Pajor L,Révész J,Sükösd F,Maráz Adoi
10.1556/650.2018.31105subject
Has Abstractpub_date
2018-08-01 00:00:00pages
1317-1325issue
32eissn
0030-6002issn
1788-6120journal_volume
159pub_type
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